Lecture 22 Haemophilis

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Lecture 22 Haemophilis

  1. 1. ‫بسم ا الرحمن الرحيم‬ GENUS: HAEMOPHILUS Prof. Khalifa Sifaw Ghenghesh
  2. 2. • Small, Pleomorphic G-ve Rods • Require Growth Factors – Two factors > X & V – X = haemin – V = Nicotinamide adenine dinucleotide (NAD) = NAD phosphate (NADP) • BA • Chocolate agar
  3. 3. Species Growth Factor Required ---------------------------------------------H. influenzae X+V H. parainfluenzae V H. ophrophilus X H. ducreyi X ----------------------------------------------
  4. 4. Haemophilus influenzae • Smooth and rough colonies occur • Capsulated >> • Non-capsulated >>
  5. 5. ANTIGENIC STRUCTURE 1. The capsular polysaccharide antigens: • 6 serotypes: a - f. • Encapsulated H. influenzae >> Quellung (capsular swelling) reaction. 2. Somatic antigens:
  6. 6. VIRULENCE FACTORS • i. Capsule: • ii. Outer membrane components: • OMP & LOS • iii. Adherence: • iv. IgA proteases:
  7. 7. PATHOGENESIS • Normal Carriage – H. influenzae > Human parasite – Non-capsulate HI > nasopharynx or throat of 25-80% of healthy people – Capsulate strains in 5-10% – Immunization with conjugate vaccine > • Invasive infections • Non-Invasive Disease
  8. 8. INVASIVE INFECTIONS H. Influenzae type b Respiratory portal of entery (Inhalation) Colonization of nasopharynx Penetration of submucosa Invasion of Bloodstream Meningitis, Epiglottitis, Bacteraemia Pneumonia, Septic arthritis Non-Capsulate HI: > Meningitis and Septicaemia > the Neonate
  9. 9. NON-INVASIVE DISEASE • Local Infections: – Physiological or Anatomical Abnormalities – Otitis Media, Sinusitis – Purulent episodes > patients with exacerbations of chronic obstructive airway disease – Non-capsulate strains of HI – Viral Infections ?
  10. 10. LABORATORY DIAGNOSIS 1. Direct examination: – Specimen: CSF, middle ear aspirate, sputum (purulent). 2. Culture: – Chocolate agar + CO 2 – Blood culture bottles – Antigenic detection – Molecular Techniques
  11. 11. Blood agar plate culture of Haemophilus influenzae
  12. 12. Haemophilus influenzae satelliting around Staphylococcus aureus
  13. 13. TREATMENT • - Systemic illness – 3rd Generation cephalosporins – TMP-SMZ, Ciprofloxacin, Clarithromycin • - Otitis media in children • - Pneumonia in adults • - Acute sinusitis – Amoxicillin, Augmentin, Clarithromycin, PREVENTION • Vaccination
  14. 14. • Haemophilus influenzae biogroup aegyptius (Haemophilus aegyptius) – Epidemic conjunctivitis – Brazillian purpuric fever • Haemophilus ducreyi> Chancroid • Haemophilus parainfluenzae

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